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Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients.

Abstract

OBJECTIVE

To examine the use of implicit and explicit measures to predict adolescent nonsuicidal self-injury (NSSI) before, during, and after inpatient hospitalization.

METHOD

Participants were 123 adolescent psychiatric inpatients who completed measures at hospital admission and discharge. The implicit measure (Self-Injury Implicit Association Test [SI-IAT]) and one of the explicit measures pertained to the NSSI method of cutting. Patients were interviewed at multiple time points at which they reported whether they had engaged in NSSI before their hospital stay, during their hospital stay, and within 3 months after discharge.

RESULTS

At baseline, SI-IAT scores differentiated past-year self-injurers and noninjurers (t121 = 4.02, p < .001, d = 0.73). These SI-IAT effects were stronger among patients who engaged in cutting (versus noncutting NSSI methods). Controlling for NSSI history and prospective risk factors, SI-IAT scores predicted patients' subsequent cutting behavior during their hospital stay (odds ratio (OR) = 8.19, CI = 1.56-42.98, p < .05). Patients' explicit self-report uniquely predicted hospital-based and postdischarge cutting, even after controlling for SI-IAT scores (ORs = 1.82-2.34, CIs = 1.25-3.87, p values <.01). Exploratory analyses revealed that in specific cases in which patients explicitly reported low likelihood of NSSI, SI-IAT scores still predicted hospital-based cutting.

CONCLUSION

The SI-IAT is an implicit measure that is outcome-specific, a short-term predictor above and beyond NSSI history, and potentially helpful in cases in which patients at risk for NSSI explicitly report that they would not do so in the future. Ultimately, both implicit and explicit measures can help to predict future incidents of cutting among adolescent inpatients.

Authors+Show Affiliations

Teachers College, Columbia University, New York. Electronic address: cha@tc.columbia.edu.Boston Children's Hospital.Boston Children's Hospital.Boston Children's Hospital.Boston Children's Hospital; Harvard Medical School, Boston.Harvard University, Cambridge, MA, Boston Children's Hospital, and the Center on the Developing Child at Harvard University.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26703911

Citation

Cha, Christine B., et al. "Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients." Journal of the American Academy of Child and Adolescent Psychiatry, vol. 55, no. 1, 2016, pp. 62-8.
Cha CB, Augenstein TM, Frost KH, et al. Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients. J Am Acad Child Adolesc Psychiatry. 2016;55(1):62-8.
Cha, C. B., Augenstein, T. M., Frost, K. H., Gallagher, K., D'Angelo, E. J., & Nock, M. K. (2016). Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 55(1), pp. 62-8. doi:10.1016/j.jaac.2015.10.008.
Cha CB, et al. Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients. J Am Acad Child Adolesc Psychiatry. 2016;55(1):62-8. PubMed PMID: 26703911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients. AU - Cha,Christine B, AU - Augenstein,Tara M, AU - Frost,Katherine H, AU - Gallagher,Katie, AU - D'Angelo,Eugene J, AU - Nock,Matthew K, Y1 - 2015/10/30/ PY - 2015/05/18/received PY - 2015/10/23/revised PY - 2015/10/26/accepted PY - 2015/12/26/entrez PY - 2015/12/26/pubmed PY - 2016/11/2/medline KW - IAT KW - prediction KW - risk factor KW - self-injury KW - self-report SP - 62 EP - 8 JF - Journal of the American Academy of Child and Adolescent Psychiatry JO - J Am Acad Child Adolesc Psychiatry VL - 55 IS - 1 N2 - OBJECTIVE: To examine the use of implicit and explicit measures to predict adolescent nonsuicidal self-injury (NSSI) before, during, and after inpatient hospitalization. METHOD: Participants were 123 adolescent psychiatric inpatients who completed measures at hospital admission and discharge. The implicit measure (Self-Injury Implicit Association Test [SI-IAT]) and one of the explicit measures pertained to the NSSI method of cutting. Patients were interviewed at multiple time points at which they reported whether they had engaged in NSSI before their hospital stay, during their hospital stay, and within 3 months after discharge. RESULTS: At baseline, SI-IAT scores differentiated past-year self-injurers and noninjurers (t121 = 4.02, p < .001, d = 0.73). These SI-IAT effects were stronger among patients who engaged in cutting (versus noncutting NSSI methods). Controlling for NSSI history and prospective risk factors, SI-IAT scores predicted patients' subsequent cutting behavior during their hospital stay (odds ratio (OR) = 8.19, CI = 1.56-42.98, p < .05). Patients' explicit self-report uniquely predicted hospital-based and postdischarge cutting, even after controlling for SI-IAT scores (ORs = 1.82-2.34, CIs = 1.25-3.87, p values <.01). Exploratory analyses revealed that in specific cases in which patients explicitly reported low likelihood of NSSI, SI-IAT scores still predicted hospital-based cutting. CONCLUSION: The SI-IAT is an implicit measure that is outcome-specific, a short-term predictor above and beyond NSSI history, and potentially helpful in cases in which patients at risk for NSSI explicitly report that they would not do so in the future. Ultimately, both implicit and explicit measures can help to predict future incidents of cutting among adolescent inpatients. SN - 1527-5418 UR - https://www.unboundmedicine.com/medline/citation/26703911/Using_Implicit_and_Explicit_Measures_to_Predict_Nonsuicidal_Self_Injury_Among_Adolescent_Inpatients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-8567(15)00691-7 DB - PRIME DP - Unbound Medicine ER -